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A letter to SSDI from my doctor

Posted Nov 21 2008 4:25pm
My attorney requested a written narrative report from my doctor to support my claim for SSDI which is now in the reconsideration stage. My doctor sent me a draft of the letter but it didn't include the last paragraph which has depressed me to no end.

Here's a copy of the letter:

I have been treating ***** since April 18, 2008. She suffers from debilitating multi-system complaints that meet diagnostic criteria for Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS). As you know, CFIDS is a legitimate medical condition, recognized by the CDC, that is unusual because its diagnosis does not depend upon objective laboratory or physical exam findings. The diagnosis is based entirely on subjective complaints, after excluding other recognized medical conditions. Of note, she has a medical history of hysterectomy, hay fever, and a past episode of adhesive capsulitis that she has recovered from. None of these medical conditions contribute to or cause her fatigue.

CDC Diagnostic Criteria for Chronic Faitgue and Immune Dysfunction Syndrome:

• Clinically evaluated, unexplained, persistent or relapsing fatigue new of definite onset; not relieved by rest; results in substantial loss of function of work, school, social or personal activities AND 4 of the following: (also, CBC, ESR, chemistry panel, TSH, etc must be normal)
o Self-reported impairment in short term memory or concentration
o Sore throat
o Tender cervical or axillary nodes
o Myalgia
o Multi-joint pain, no swelling or erythema
o HA of new pattern and severity
o Unrefreshing sleep
o Post-exertional malaise lasting greater than or equal to 24 h

She meets diagnostic criteria for CFIDS. The symptoms started in July 2007. She demonstrates absence of any other medical or psychological condition that could account for these symptoms (absence of hypothyroid, blood dyscrasias, normal CBC, ESR, chemistry panel, etc). She has profound disabling relapsing fatigue lasting > 6 months not relieved by rest. She has self-reported impaired memory, myalgias, headaches, unrefreshing sleep, post-exertional fatigue and malaise lasting more than 24 hours. She has intermittent sore throat, tender lymph nodes and joint pains.

Of note, she does have some positive bands on Western Blot for borrelia but does not meet case definition for Lyme. She is undergoing empiric treatment for babesia and lyme, though as stated above, lab evidence does not support this diagnosis.

She has received nutritional and graded exercise counseling and is following through on treatment recommendations, though her clinical improvement has been minimal. She also has IgG antibody positivity to HHV-6 and EBV.

She must rest or sleep 19-22 hours per day because of the profound fatigue.

Functional Capacity:
Standing: less than 15 minutes at a time, limited by faitgue
Sitting: can sit for an hour at a time, limited by fatigue
Concentration: significantly impaired to a degree that would prevent desk work
Lifting, bending, pushing, pulling: cannot do any of these activities secondary to fatigue

Her prognosis is poor. CFIDS is a devastating illness that frequently lasts 10 or more years. However, some patients do recover sooner. She will continue treatment and we will follow her progress, hoping that she may recover in the next few years.

Please let me know if I can be of further assistance.



I have an appointment with him on Tuesday. I plan on asking him if he believes my prognosis is poor or if he wrote that because it would help my case. I'm trying to console myself that he wrote it to help my case though I know in my heart he's not the type of person to exagerrate things.

My lawyer thought it was a great letter. He and I don't have the same perspective though. I can't live like this for a few more years much less 10 or more. I don't know how some people do it.

Am I destined to end up alone in Section 8 housing or worse, a nursing home? The most horrible thing about this illness is it doesn't kill you quickly. It's a slow, slow death all the while watching from the sidelines as your life disappears before you as if some magic trick. I'd like to talk with the magician and let him/her know that I'm ready for the trick to be over.
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